Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0106X | Oral and Maxillofacial Pathology | 18404 | TX |
NPI | 1700860160 |
---|---|
Provider Name | Dr. Stephen B Williams |
First Address | Silver Spring, MD 20910-2153 |
Second Address | Washington, DC 20306-0001 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/11/2005 |
Last Update Date | 08/07/2007 |